{
"Npi": {
"NPI": "1467868661",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "AUTEN",
"FirstName": "KELLEY",
"MiddleName": "MILLER",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PHARMD, CPP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "MILLER",
"OtherFirstName": "KELLEY",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PHARMD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1126 N CHURCH ST STE 300",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREENSBORO",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27401-1037",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "336-938-0800",
"MailingAddressFaxNumber": "336-938-0757",
"FirstLinePracticeLocationAddress": "1126 N CHURCH ST STE 300",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GREENSBORO",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27401",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "336-938-0800",
"PracticeLocationAddressFaxNumber": "336-938-0757",
"EnumerationDate": "07/08/2014",
"LastUpdateDate": "08/30/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "24253",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "1835P0018X",
"TaxonomyName": "Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"LicenseNumber": "700102",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}